Hydatid disease caused by Echinococcus granulosus is endemic in Indian subcontinent and a common surgical problem. Although occurrence of hydatid cyst is common in liver and lungs, it can be encountered in almost every part of the body. Combined mediastinal and pericardial hydatid disease is a rare occurrence and only a few cases have been reported in the literature. Patients with hydatid cysts are usually asymptomatic. Our case report demonstrates a 57-year-old female patient who presented with chest pain and dyspnea on exertion for few months duration. Detailed imaging and laboratory investigation revealed a pericardial and mediastinal hydatid cyst. The patient underwent operation for curative excision. After surgery, the patient's symptoms resolved and his clinical status improved.
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